Deep learning vessel segmentation and quantification of the foveal avascular zone using commercial and prototype OCT-A platforms

Abstract: Automatic quantification of perifoveal vessel densities in optical coherence tomography angiography (OCT-A) images face challenges such as variable intra- and inter-image signal to noise ratios, projection artefacts from outer vasculature layers, and motion artefacts. This study demonstrates the utility of deep neural networks for automatic quantification of foveal avascular zone (FAZ) parameters and perifoveal vessel density of OCT-A images in healthy and diabetic eyes. OCT-A images of the foveal region were acquired using three OCT-A systems: a 1060nm Swept Source (SS)-OCT prototype, RTVue XR Avanti (Optovue Inc., Fremont, CA), and the ZEISS Angioplex (Carl Zeiss Meditec, Dublin, CA). Automated segmentation was then performed using a deep neural network. Four FAZ morphometric parameters (area, min/max diameter, and eccentricity) and perifoveal vessel density were used as outcome measures. The accuracy, sensitivity and specificity of the DNN vessel segmentations were comparable across all three device platforms. No significant difference between the means of the measurements from automated and manual segmentations were found for any of the outcome measures on any system. The intraclass correlation coefficient (ICC) was also good (> 0.51) for all measurements. Automated deep learning vessel segmentation of OCT-A may be suitable for both commercial and research purposes for better quantification of the retinal circulation.